Creating Community Partnerships

Recently Karl and I met to discuss the exciting growth in collaborations and the developing partnership between Leeds Metropolitan University (Leeds Beckett University from 22 September) and York Street Health Practice. These collaborations reflect a new and innovative way of working in, and for the community between the NHS and education.

Karl works on the CommUNIty Initiative which is based in the Faculty of Health and Social Sciences at Leeds Met University. CommUNIty has an overarching goal of finding new more effective ways to improve health and reduce health inequalities in the region. It aims to achieve this through supporting the development of meaningful, sustainable and mutually beneficial relationships between Leeds Met. and community/voluntary organisations. Practically, this means scoping out current partnership work within the university, building rapport with university staff and community partners, seeking ways to share knowledge and resources, and proactively seeking out opportunities for future collaboration. Formally established in 2013, CommUNIty has developed from the collaborative work of Prof. Jane South and colleagues in the Faculty, particularly the strategic partnership work with Hamara healthy living centre in Beeston. What the collaboration with Hamara has and continues to demonstrate, is that investment in a sharing and open relationship with community organisations has benefits not only for the academic institution and the community partner, but also the broader community in which the work is situated.

Community partnerships, supported by the CommUNIty initiative with the likes of Leeds Community Healthcare Trust and St. George’s Crypt offer universities a multitude of benefits. They offer opportunities for research and teaching, allowing academics and students to access knowledge from people who are delivering practices being taught in the classroom, and experiential knowledge from people who are receiving services. Conversely these partnerships enable the academic community to share knowledge garnered through research, with community partners and promotes joint working to ensure findings are presented and disseminated in a ways which meet the needs of the target audience. Partnership working also offers opportunities for staff and students to share and develop their skills in the community through volunteering and placements and provides opportunities for widening participation in teaching and research.

As we sat drinking coffee talking about how our services were working together we ended up talking about the essence of what good partnership means and looks like. We often presume good partnership work exists. But what does it look like? What are its component parts? Three things came to mind in the discussion, of course many other key aspects could have been mentioned too. The three things were service, strengths and steer. These three are the glue and life to what make compassionate and successful partnerships. They are glue because they hold partnerships together. They are life as they breathe creativity, energy and vision into partnerships.

Service has to be at the heart of all good partnership work. The day we forget people is the day the rot starts. People and their service have to be at the centre of all we try to do and accomplish. Every circle has and needs a centre. Nature abhors a vacuum and if people aren't the substance of our work other things will rush in to fill the absence. We miss the point if we miss the people. One of the authors remembers years ago hearing a tape by a business sales trainer. In it he asked his audience 'What is the purpose of a business? 'To make a profit' they called back. 'No' he said, 'You're wrong.'   It's to make and keep a customer. If you do this the profit will follow as night follows day. And to keep a customer we have to treat people well and with honesty and respect.' The trainer knew the truth. It's all about people and service.

Partnerships are places where we offer our strengths and gifts to make things happen. We found ourselves in our conversation using the analogy of partnerships being people who bring different strengths to the table to share and create something new. These strengths are usually what our work roles are. They are also what life and loved ones have taught us. Steve Jobs, founder of Apple, talked about how as a child he got electronic kits which as well as giving him electronic know how gave him a real level of self-confidence. Our gifts make and sustain partnerships, so does our lack. What we don't have teaches us the value of the other. What other colleagues bring enriches and shapes our experience and practice. Partnerships are spaces for our gifts to contribute. They are also arenas to discover our latent talents and possibilities. Partnerships teach us to be humble too. We don't know it all, we need each other.

The last aspect is steer, or steering. In business and leadership circles this means to lead and give direction. The book by Jean Philippe Deschamps sums it up.  It's called 'Innovation Leaders: How Senior Executives Stimulate, Steer and Sustain Innovation.' Partnerships without good leadership are like a car without a steering wheel or a ship without a rudder. The leadership steers the partnership onward and forward looking. What is good leadership? There are many answers to this. One answer is that good leadership - in fact great leadership - isn't about what we've got - it's about what we give. Think about great leaders such as Martin Luther King and Nelson Mandela. They gave all to the cause they committed themselves to. Dr King paid the ultimate price with his assassination. Nelson Mandela spent over 20 years in prison. Thankfully, we will probably not be asked to make these sacrifices. But, we can learn the lesson that great leadership often means great giving. There's a secret here, giving has a boomerang effect. We may give but it often comes back to us in different ways and forms. Some of the best partnerships in the city happen because those involved give and give to make it work, and yet the returns on this investment are often much greater than the sum of what has been put in.

Partnerships are the future of this city. We are happy and feel honoured to be involved in the building of them. The 6th President of the United States, John Quincy Adams, said, 'If your actions inspire others to dream more, learn more, do more and become more, you are a leader.'  Dreaming, learning, doing, leading and becoming more - these are the charter and content of the partnership we are working to bring about. In difficult days for so many these are signs of hope and new ways of working.

John Walsh, York Street Health Practice

Karl Witty, Team Lead for CommUNIty Partnerships, Faculty of Health and Social Sciences, Leeds Metropolitan University 

Meet our staff...

Sharon Underwood, a Health Visitor with the Early Start Team has been awarded the Deans Prize by Leeds Metropolitan University following the completion of her Master’s in Public Health. 

“After a break from studying after my first degree in health visiting, I decided to start a new course and discovered the MSc in Public Health: Health Promotion at Leeds Metropolitan University. Completing the course was as much about doing something for my own personal achievement as well as knowing it would assist with my everyday role as a Health Visitor.

There have been many elements to the course that I have found interesting, one of which was my research project for my 12,000 word dissertation. I decided to look in to the attitudes parents have towards supplying alcohol to their underage teenagers.

Alcohol consumption in adolescence is a source of increasing concern. In England, it is illegal for persons under the age of 18 years to purchase alcohol, and the reduction or prevention of under-age alcohol consumption is a government priority, with supply of and access to alcohol being key aims in the national strategy. The Department of Health’s Chief Medical Officer advocates that an alcohol-free childhood is the healthiest and best option for children. However, research implies that the consumption of alcohol by young people frequently ignores these recommendations.

Parental supply has been identified within a number of studies as a significant point of access to alcohol by teenagers. They may do this for many reasons; to demystify drinking alcohol, be in control of how much they consume or some see it as a rite of passage. A recent Drinkaware study identified a correlation between parental drinking habits, and influences upon children. I specifically chose to recruit and interview parents, aged between 44 and 64 years, from middleclass families as research shows there is an increase in the weekly drinking habits of this group. 

Of the seven parents I spoke with there was a varying degree of attitudes, awareness and lack of knowledge. One mum even took away with her some prompt cards describing different scenarios where her children may her approach her for alcohol to use during discussions with her children.

It was evident through the interviews that parents aren’t given much advice and support on what they should do if their teenage son or daughter comes to them to ask for alcohol to take to a party, etc. As a nurse by background and working in the healthcare profession for 30 years, I have seen the short and long term health impacts for people and their families who have been affected by excessive drinking of alcohol and as health care professionals we should get better at having these conversations early.”

Congratulations to Sharon on her degree and well deserved prize.

You can access information and support from your local Health Centre or GP surgery or your child’s school/college pastoral services. In addition, you may find the following websites a useful source of information:

• Drinkaware: Alcohol and your child
• Drinkaware: What do other parents
• NHS Choices

Meet our staff...

Lisa, Rosie and Deanna are three Occupational Therapy students from Leeds Metropolitan University, working with Integrated Services. During their three month placement, they have been undertaking a project, which they explain below.

We are a group of three students studying Occupational Therapy at Leeds Metropolitan University, currently on a role emerging placement with Integrated Services until the 11th July. 

For role emerging placements, students enter into a non-traditional placement setting and introduce or expand the role of occupational therapy within the service and develop a project around this. Occupational therapists (OTs) enable people to overcome obstacles which prevent them from participating in the occupations that matter to them. This may be a result of the aging process, illness, disability or other circumstances.

Our project is to promote occupational therapy to the other professionals working within Integrated Services in Beeston (where we are mainly based) who are predominantly District Nurses and Community Matrons.

During the beginning stages of the placement we gathered information to help us devise our project by shadowing nurses and OTs on client visits, conducting a focus group with OTs and surveying the nurses based at Beeston. Our rationale for the project was that most OT referrals are for equipment or adaptation provision and the OTs in Integrated Services are aiming to work more holistically. This includes enabling clients to engage in occupations that are important to them, such as being able to socialise with friends at a weekly coffee morning, being able to take their dog for a walk, or knitting a scarf for a grandchild.

As part of the project, we have created several posters which will be displayed at Beeston Health Centre, as well as leaflets which will be distributed to staff and patients, explaining the role of Occupational Therapy. During the last week of our placement, we are holding an interactive session with the nurses based at Beeston to explore the meaning of occupation and how beneficial engaging in meaningful occupations is to a person’s health and wellbeing. We will then discuss potential interventions OTs can provide, using case studies to illustrate the role of OT with several different clients.  

Our placement mentors believe there is an unmet need where occupational therapy could improve clients overall health and wellbeing (e.g. clients experiencing social isolation, disruption in roles and routines) however due to the perception of OT within the service these clients are not getting referred. Integrated working requires professionals to understand one another’s roles so we believe promoting OT to other professionals will serve this purpose while also addressing the unmet need of clients. We hope that when the placement is finished our mentors will continue to use the resources we have produced to promote OT across Leeds. 

Lisa Downing,  Rosie Longshaw and Deanna Stephens

Men, Health and Hope

 

Last week saw International Men's Health Week celebrated at St George's Crypt in Leeds (from Monday 9 June to Friday 13 June). The aim was for homeless men in Leeds to receive a week of wellbeing and health actions and events, an idea formed by Kim Parkinson at the Crypt. Kim is the training and housekeeping mentor and a great force for good among homeless people. This idea led to an initial meeting with Andrea North and myself from Leeds Community Healthcare NHS Trust (LCH), Alan White, Professor of Men's Health Studies at Leeds Metropolitan University, Jade, a social work student at Big Issue in the north, and Kim to plan and design the format and spirit of the week. Rob Newton from the Institute of Health and Wellbeing and the Health and Wellbeing Board at Leeds City Council and Karl Whitty, research officer in the Centre of Men's Health at Leeds Met joined us shortly afterwards.

 

We, as a meeting of forces, representing the local authority, health, third sector, faith sector and education, were able to create an amazing week of events. The week included massage, meditation, podiatry, theatre, physical fitness, haircuts, song and pamper bags for the men. Running throughout were a series of positive and yet serious health messages. Health professionals from a variety of LCH services (including Tuberculosis service, Community Dental, York Street, Healthy Lifestyles Service) attended, offering connection and conversation. We deliberately moved away from a model of formal structured consultations to conversations over food and coffee - to share, engage and listen. Age UK Leeds joined the week as did Leeds and York Partnership NHS Foundation Trust. Our Primary Mental Healthcare Service provided information leaflets.

 

The event was opened by Cllr Roger Harrington, Chris Fields, CEO at the Crypt and Professor White. On Thursday, Cllr Lisa Mulherin, the chair of the Health and Wellbeing Board visited the event in support. Lisa has consistently supported these events and we are grateful for her support and voice for the poor and vulnerable of our city. Andrea North and Catherine Hall, two other great supports of these initiatives at LCH also, in their busy work lives, attended to support. A big thank you too to Sarah Elwell, the new communications officer at LCH who did an incredible job managing the photography, press release, partnership agreements, Twitter, Facebook and other media actions in such a professional and helpful manner.

I was in London for the first two days at health events so missed the start of the week. I did attend the last three days and was touched by many things. Three themes shine through. The first was the theme of 'space and place'. The Crypt is an incredible centre of welcome and wellbeing. They are one of York Street's best partners and we always try to support their good work. This brings home to me one of the key aspects we use at York Street as part of our model of work.  The people who come to the Crypt and York Street are those who often have no positive space or place in their lives. From the asylum world, they may be people who have been tortured, imprisoned or raped. In the indigenous homeless world, the vast majority of those we have the honour to try to support have problems going back to childhood. We work to create what the theorists call 'psychologically informed environments', places and spaces where people can feel welcome and accepted. The Crypt and York Street are such places as are many places in this city. The creation and development of these spaces is crucial to the human development and recovery of the homeless and vulnerable.

The second theme was that of the homeless people themselves. On Wednesday when I arrived, I sat down and  looked out at a sea of faces, each etched with stories and I'd guess, in most cases, pain and loss. It was at that moment that a former client of mine came up and gave me a big hug. I had worked with her a number of years ago. As I sat with her and listened to her present story I heard of  the struggles and setbacks as she was trying to build a more positive and healthier life. In the centre of the difficulties and pain there was also hope. This was not someone giving up but keeping on to try to get to where she needed to be. In this woman, there was the courage, the hope and belief that things, including her own life, could get better. This is what inclusion and wellbeing work is all about. It's when people can find their hope and strength that changes can really start to happen. Talking to men over the three days I had the same experience. Sensing the heavy issues people carried yet a not giving up spirit - a hopefulness against so many odds. If we ever lose sight that is what our work is really about, then that will be a really sad day. If we forget the people, we lose our way. Isn't that what the tragedy of Mid Staffs teaches us? On the Monday evening I was at an event in London with the top 50 nurse leaders in the UK, truly amazing people. I was there as guest of my good friend and mentor, Yvonne Coghill, the national lead for inclusion at the NHS Leadership Academy. Yvonne walks the national stage in the NHS. She is one of the leaders in this great service of ours. Although she never mentions it, she also makes time, again and again, to reach out and support people in the most vulnerable positions. If we ever wish to know what 'best leadership' looks like, this is it. Concern for people has to be at the heart of what we do.

The third aspect was how we all working together made a difference. Apart we are little. Together we make a powerful impact. Sometimes people see effective partnership work as some arcane art that 'business gurus' can teach us to generate. The truth is much simpler. Good partnerships happen when people who care connect. This is what happened at Men's Health Week at the Crypt. People who cared enough to put aside time to meet and act came together to do something. My mind fills, as I try to write this, with images of this in practice. Professor White sat with homeless men at a table talking about their health. Alex Hammond and his team from Healthy Lifestyles Service going straight into action connecting with men about how they can make positive changes. Dawn and Gill from the Community Dental Team at Armley smiling and talking about dental care to the men. Urban Spawl and Opera North offering arts, drama and theatre. Dr Phil Commons from Leeds Met with physical fitness. LYPFT were represented by my friend and colleague, Ken Cattle. Ken is a former mental health service user and now has dedicated his life to working with people in the community with mental health problems. Ken was an amazing presence talking to and connecting with the men there. Talking about mental health is not always easy but Ken did it again and again. The week made me proud of what we can do together, what we can be together. We have in Leeds 12 integrated care teams bringing together health and social care. These teams work to provide the best, quickest and most effective responses to those in the community. I saw at the Men' Health Week the same spirit, promise and potency. This city has a great health and wellbeing vision - 'that Leeds will be a caring and healthy city where the poorest receive healthcare the fastest'. I saw that happen at Men's Health Week. It really shows we can do it. If we can build on these experiences we can realise the vision and then Leeds may end up as, not just best city for health and wellbeing in the UK, but in Europe too.

The late Maya Angelou once wrote that, "I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel." I doubt any of us who participated in the week will forget how we felt in trying to make a difference. I also don't think we'll forget those faces looking to us for support and help.

 

John Walsh, York Street Practice

 

 

 

A local partnership with global impact

John Walsh, of York Street Health Practice, discusses his recent trip to Prague as part of a learning programme on street work...
 

In May I joined a group of students and academics from Leeds Metropolitan University (LMU) to travel to Prague to take part in and work to develop a powerful and innovative learning experience. This was the intensive learning programme on street work between four universities, LMU, Barcelona, Amsterdam and Prague, to which the project forms part of a three-year Erasmus-funded Intensive Programme (IP), which initially began in 2013.

 

The Leeds teaching programme, which is led by Darren Hill and Dr Erika Laredo from LMU, creates the space for 40 students from across the four universities to work with academics and practitioners on street work, research, theory and practice. The students come from a range of backgrounds including social work and youth work and had all done preparatory work on issues of homelessness, addiction and social theory. 

This was a great example of how Leeds, in all it's rich complexities of academics, practitioners, students and former service users, could come together to learn and debate options and approaches across countries. Darren Hill, senior lecturer in social work at LMU and co-organiser of the programme, summed up well what this meant: "The students and staff will be studying international street work, visiting homeless projects in Prague, designing research proposals and sharing their skills and experiences. We hope that it will encourage the students to go into masters degree level study and move into street work practice. By drawing together a range of academics and professionals across a variety of disciplines, we aim to address the new knowledge and skills that professionals working within a street context will require over the next decade." More details about this can be found on the LMU website.

My memories of the two weeks are positive and plentiful, with particular things standing out. One was that the Prague conference on the ground was run and overseen by just one person - Barbara Janikova. Barbara is lecturer in the Department of Addictology, First Faculty of Medicine at Charles University in Prague. I was amazed at how one person supported us all and organised the operation on the ground, day after day. She was always there helping students and staff and we were all inspired by her. On the last day at the final meal, we were able to celebrate her and all she had done for us. While it is true that Barbara is an extraordinary person, it showed me again how one person can make a massive difference. It is a lesson I see often in the NHS and elsewhere, that it is really the people that matter. If we get the right people, people of care and vision, all the rest can follow. Without this, I think we run into real problems.

During the two week teaching experience, Jo Smith, my colleague from Leeds Adult Social Care, and I took part in different sessions. Jo is a mental health social worker for the homeless and works in the Mental Health Homeless Team, which is part of Leeds City Council, as well as in the CRI Street Outreach Team. Each day we ran sessions to encourage the students to meet and take part in interactive work; this was to support cross national discourse, discussion and work.

We worked with tutor groups looking at different aspects of teaching and research. My group looked at drug issues and visited an inspirational project, which works with those with drug problems in the city of Prague. It was interesting to hear about their challenges and work and it struck me how in Leeds, we are very fortunate to have built and continue to build strategic alliances for the poor and the vulnerable. These alliances see inclusion as not just including marginalised groups but address how a whole city can and should develop positive health and wellbeing agendas, vision and practice. This allows the generation of work from the bottom up and top down to occur and really start to change things. Two examples of this are the Leeds Health and Wellbeing Board Vision and the innovative work around homeless hospital discharge work (Homeless Accommodation Leeds Pathway (HALP), which Leeds Community Healthcare NHS Trust and York Street Practice have been key workers in). One person (who has extensive experience in services and service development) and attended the HALP launch in January commented to me recently how, when they attended the launch event, they were impacted by the incredible positive energy in the room and how everything was joined together, from the streets to strategic levels.

We used a variety of forms to teach and share in the two weeks. One interesting format was a staged debate between myself and my friend and colleague, Dr Asun Llene Berne, professor of Theory and History of Education at the University of Barcelona. I was asked to take the proposition that in times of austerity research should not be funded and the funding should go into practice and services. Asun argued that practice without research is lost, hence funding was necessary. The debate took place and we both presented our cases. I was struck by the high level of discussion, reflection and co-learning that the debate and the overall teaching experience created.  I believe with Darren, Erika, Asun, Barbara, Jo and other good colleagues such as Sue Lindsay, we already see international and innovative ways of learning and practice emerging. This offers new possibilities of health and education working in positive partnership to generate quality research, an improved discourse on the needs of our most vulnerable people and the evolution of the most compassionate and effective care possible.

Colleagues at LMU have written an article on York Street Health Practice (click here to read). In it they have a fantastic quote that this a is local partnership with a global impact. I hope we can build this into a living ongoing experience, which can generate a new international dynamic model  of collaborative work, research and practice. I'm proud that Leeds Community Healthcare NHS Trust are involved in something so potent and promising.

 

John Walsh

York Street Health Practice